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Survey about CMS pain codes and value-based care delivery

AACIPM is hosting a webinar, in partnership with the US Pain Foundation, to take a closer look at the pain codes that the Center for Medicare & Medicaid Services (CMS) released in early 2023 and how they are impacting value-based care for high-impact pain. This webinar will also explore innovation and progress in scalable, value-based care delivery models.

In 2021, CMS (the single largest payer of healthcare in the US) announced the goal that its Medicare and Medicaid beneficiaries will be in a relationship with accountability for quality and total cost of care by 2030 – in other words, value-based care.

Results from the survey below about the CMS codes + value-based pain care will be discussed among esteemed panelists during the December 7, 2023 webinar (details and registration here), so please take about 5-10 minutes to complete these questions.

This survey has been developed with input from staff or volunteers with US Pain Foundation, AMA, AAFP and AAPM. This is intended to provide more insights about the integration of value-based comprehensive chronic pain management and the process of paying for these care management services.

We encourage you to share this survey and webinar registration with your networks to increase the impact of these advocacy efforts!

Related Resource links: CMS Fact sheet, AAFP link, AMA link, AAPM Fact sheet, ASRA link, ASAM link, AACIPM link, AACIPM links

Begin Survey

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Step 1 of 3

33%

What setting best describes where you work?

What setting best describes where you work?

Solo practice

Group practice

Employed physician practice

Direct primary care

Independent contractor

Other

Do you already use chronic care management CPT codes, such as 99490, 99491, in your practice (e.g., CCM, PCM, behavioral health)?

Do you already use chronic care management CPT codes, such as 99490, 99491, in your practice (e.g., CCM, PCM, behavioral health)?

Yes

Do these codes allow you to do more care management than before you used them?

Do these codes allow you to do more care management than before you used them?

Yes

Comments

Comments

Are you/your colleagues aware of the new pain management codes released in January 2023 Physician Fee Schedule?* *

Review CMS Fact sheet

Are you/your colleagues aware of the new pain management codes released in January 2023 Physician Fee Schedule?*

Yes

Are you interested in learning more about these codes?

Are you interested in learning more about these codes?

Yes

Does your hospital or clinic normally let you know about new codes such as this?

Does your hospital or clinic normally let you know about new codes such as this?

Yes

Have you used these codes in your practice?

Have you used these codes in your practice?

Yes

Are you able to currently locate these codes (G3002 and G3003) when searching your electronic health record system?

Are you able to currently locate these codes (G3002 and G3003) when searching your electronic health record system?

Yes

Do you or a delegate access the PDMP in your state?

Do you or a delegate access the PDMP in your state?

I check the PDMP

We have delegate authority in our state and they check it

I don't use the PDMP

Other

What successes have you experienced re: using these codes?

What successes have you experienced re: using these codes?

Accounting for time being spent with patient to discuss chronic pain care

Accounting for time being spent talking about patient with other providers

Accounting for time being spent to coordinate care/recommend other providers

Improved outcomes

Increase in revenue

Other

If other, please specify.

If other, please specify.*

What roadblocks have you experienced re: these codes? (choose all that apply)

What roadblocks have you experienced re: these codes?

Economic challenges

Would require clinical practice transformation to implement

Don’t have enough need among my patient base

Need to reorganize staffing and current practice infrastructure

Concerns that CMS will create penalties for doing this incorrectly

Concerns that CMS will change course based on fraudulent claims

Lack of priority among leadership

Concerns about double billing (e.g., similar E/M codes)

Currently using E/M codes, traditional codes for this care

Already feel overwhelmed with time required for documentation in electronic medical record

Lack of knowledge about how to effectively implement

Other

If other, please specify.

If other, please specify.*

Please describe in your own words what you think about the idea of these codes for “bundling” chronic pain management

Please describe in your own words what you think about the idea of these codes for “bundling” chronic pain management/

Do you outsource billing?

Do you outsource billing?

Yes

Approximately how many or what percentage of your patients have high-impact chronic pain?

Approximately how many or what percentage of your patients have high-impact chronic pain?

Do your patients typically want to try integrative therapies (e.g., acupuncture, massage, spinal/osteopathic manipulation, yoga therapy, occupational therapy)

Do your patients typically want to try integrative therapies (e.g., acupuncture, massage, spinal/osteopathic manipulation, yoga therapy, occupational therapy)?

Yes

As currently coded (not a “Designated Care Management Service”), clinical staff time may not be billed incident to a physician’s services where outsourced clinical staff is not in the same physical location as the physician. Are you able to capture the need for this “incident to” billing, so that, if needed, we can share this information with CMS more readily?

Yes

Aside from any potential barriers, do you believe these codes are important and necessary when caring for patients with chronic pain?

Aside from any potential barriers, do you believe these codes are important and necessary when caring for patients with chronic pain?

Yes

Is your office using or trying to use these codes?

Is your office using or trying to use these codes?

Yes

What would help you to do so more effectively?

What would help you to do so more effectively?*

Do you participate in a value-based clinical care system?

Do you participate in a value-based clinical care system?

Yes

Not sure

Comments

Comments

What are the reasons you do not participate in a value based care system?

What are the reasons you do not participate in a value based care system?

Challenges with fee-based payment structure

Interested but not aware of models that would allow this to be successful

Lack of motivation from leadership to make changes

Would need to change overall infrastructure and this is difficult

Current practice is working well overall for addressing patients’ needs

Other Comments/Feedback

Other Comments/Feedback

Can you share more information about this system so that we can continue to collect examples of equitable, person-centered, quality pain care?

Can you share more information about this system so that we can continue to collect examples of equitable, person-centered, quality pain care?

How likely are you to adopt a value-based clinical care system?

How likely are you to adopt a value-based clinical care system?

Very Likely	Likely	Not sure	Unlikely	Very Unlikely

Do you consider yourself an early or later adopter of value-based care?

Do you consider yourself an early or later adopter of value-based care?

Early

Late

Not sure

What resources would you appreciate having in order to learn more about models for value based care?

What resources would you appreciate having in order to learn more about models for value based care?

Other comments/feedback

Other comments/feedback

Thank you for your participation!

We will summarize the results from this survey and share before the webinar on Dec. 7. Please leave your contact information so we can share the results with you.

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